Family Violence Services

Overview

Family violence — sometimes called domestic abuse — is when one person in a close relationship uses fear, control, or force over another. It can happen between partners or ex-partners, and also between other family members, such as parents and adult children, siblings, or carers. It is not only about hitting. It includes emotional cruelty, threats, constant criticism, being kept away from friends and money, being watched or tracked, pressure about sex, and being stopped from making your own decisions. Family violence services are the people and organisations that help: doctors and nurses, specialist support workers, refuges (safe housing), counsellors, and legal advisers. Their job is to believe you, help you stay safer, and support whatever choices you decide to make.

Yes, it is very common. Health services around the world see it every day, and it happens in every kind of family, income level, religion, and culture. If you are living with it, you are not alone and you are not unusual.

Anyone can be affected, at any age. It happens to women, men, and people of all genders, in straight and same-sex relationships, and within families. Some people face extra barriers to getting help, including people with disabilities, older adults who depend on a carer, pregnant women, young people in their first relationships, people whose immigration status depends on a partner, and people with little money or limited English. Services exist to help with these barriers too.

Symptoms

Common symptoms

• Unexplained bruises, cuts, burns, or injuries — especially to the head, neck, face, or body, or in patterns that do not match the story of how they happened
• Injuries that are explained vaguely, or explanations that keep changing
• Delay in getting medical care, or a partner who insists on staying in the room and answers questions for you
• Feeling afraid of your partner or a family member, or feeling you have to be careful all the time about what you say or do
• Being checked on, followed, tracked by phone or apps, or having your messages and money controlled
• Being cut off from friends, family, work, or money
• Being put down, humiliated, or told you are worthless, or told that you are the one with the problem
• Being pressured or forced into sex, or into sex you did not agree to
• Sleep problems, constant tension, panic, low mood, or feeling numb
• Repeat visits to the doctor or emergency department with pain, injuries, or stress-related problems
• Problems in pregnancy such as bleeding, pain, or injuries to the bump

Symptoms in children

• Behaviour changes: becoming withdrawn, clingy, angry, or very eager to please
• Going backwards in development — bedwetting, thumb sucking, or baby talk
• Nightmares, trouble sleeping, or fear of going home
• Headaches, tummy aches, or other body complaints with no clear cause
• Trouble at school: falling grades, missing school, or trouble concentrating
• Being overly rough with others, or being bullied
• Being hurt while 'breaking up a fight' between adults, or being used as part of the control
• Acting like a parent to younger siblings, or trying to keep the peace at home

Symptoms in older adults

• Injuries that do not match the explanation, or that keep happening
• A carer or family member who controls visits, phone calls, money, or medication
• Being given too much medicine, or having medicine or food withheld
• Signs of neglect: poor hygiene, weight loss, untreated sores, or a messy, unsafe home
• Sudden confusion, fearfulness, or reluctance to speak when a certain person is present
• Money going missing, unusual bank activity, or pressure to change a will
• Being told you will be put in a care home unless you do as you are told

Causes

Main causes

• Family violence is caused by the person who chooses to use control and fear. It is not caused by the victim's behaviour, appearance, spending, cooking, drinking, or mental health.
• Common patterns include believing one person should be in charge, using anger as a way to control others, and growing up around violence where it was treated as normal.
• Stressors such as money problems, alcohol or drug use, or job loss can make abuse worse or more frequent, but they are not the reason for it.
• Some abuse comes from the way a person is cared for — for example a carer who is untrained, exhausted, or abusive, or family members who control an older person's money.

Risk factors

• Pregnancy and the time just after birth
• Separation or plans to leave — this is often the most dangerous period, so planning with a support worker matters
• Isolation from friends, family, work, or community
• Disability or long-term illness that creates dependence on a carer
• Money problems, poor housing, or debt
• Heavy alcohol or drug use by the person being abusive
• A history of violence in the abusive person's own childhood, or a history of violence in past relationships
• Immigration status that depends on a partner, or limited English, which can make it harder to seek help
• Young age in a first relationship, or a relationship that moved very fast

When to see a doctor

See a doctor urgently if:

• You have any injury, especially to the head or neck, or you have been choked or strangled
• You are pregnant and have pain, bleeding, or a bump injury
• You have been sexually assaulted recently
• You feel unsafe going home, or you have nowhere safe to go tonight
• You are having thoughts of harming yourself or ending your life
• A child in your home is being hurt or is in danger

Book a routine appointment if:

• You want to talk to someone confidentially, even if nothing physical has happened
• You are being controlled, watched, or put down, and you want to understand your options
• You have stress, low mood, anxiety, sleep problems, or pain that may be linked to what is happening at home
• You want a note made of an injury or incident, for your own records
• You are worried about a friend or relative and want advice on how to help
• You want information about local support, housing, money, or legal options

Diagnosis

There is no test that 'diagnoses' abuse. Instead, a doctor, nurse, or support worker will ask simple questions, usually in private, and listen carefully to what you say. In some health settings, staff ask everyone a short set of questions about safety at home — this is routine and not an accusation. They may ask about injuries, fear, control, and whether you and any children feel safe. They will also check for any injuries or health problems that need care, and may ask about your mental health and sleep. What you share is used to offer help, not to judge you.

Tests that may be done

• A physical examination, only with your clear permission, to check and treat any injuries
• Photos or written notes of injuries, only if you agree — these can be useful later
• Tests or treatment after a sexual assault, if you choose this, including emergency contraception and infection checks
• Screening questions about safety at home, mental health, and sleep
• Blood tests or scans only if needed for a specific injury or health problem
• A safety check for any children in the home, which may involve other services

What to expect at your appointment

Expect a calm, private conversation rather than an interrogation. You can say as much or as little as you like, ask for a chaperone, or ask to speak to someone on your own. Staff should explain what will happen with any information you share, including who they may need to tell if a child or someone else is at risk. They should offer you contact details for specialist services and help you plan for your safety, at a pace you choose.

Treatment

Support for family violence is not about fixing you — it is about helping you get safer and recover. The main approaches are specialist advocacy (a trained worker who helps you with practical things and stays with you through decisions), safety planning, treatment for any injuries, mental health support, housing and money help, and legal options. You decide the pace and which parts you want. Services should work with you, not make decisions for you.

Self-care at home

• Keep a simple record of incidents, injuries, and threats, with dates, in a safe place — for example with a trusted friend, in a locked drawer at work, or in a password-protected account the other person cannot access
• Learn a safety plan: safe exits, a code word with a neighbour or friend, a bag with essentials kept somewhere else, and a plan for children and pets
• Check your phone and devices for tracking or shared accounts, and ask a support worker for help with technology safety
• Keep important documents and a little money somewhere safe if you can, such as ID, bank cards, medication, and a spare phone
• Tell one or two people you trust what is happening, so someone knows to check on you
• Keep up your own health: sleep, food, movement, and any regular medication or appointments
• Be gentle with yourself. Foggy thinking, fear, and exhaustion are normal responses to living with threat, and they usually improve with support

Medical treatments

Treatment depends on what you need. For physical injuries, clinicians treat wounds, check for hidden injuries, and arrange follow-up. After a sexual assault, time-limited care such as emergency contraception and infection prevention may be offered, and specialist sexual assault services can help. For emotional effects, talking therapies — such as trauma-focused counselling or support groups — can help with fear, low mood, anxiety, and sleep. Some people are offered medication for anxiety, low mood, or sleep by their doctor as part of a wider plan; this is a decision to make with a clinician, and no specific medicine is right for everyone. Specialist domestic abuse services offer practical advocacy, safety planning, and help with housing, money, and legal steps. Refuges provide temporary safe housing. Children and young people may be offered age-appropriate support too. All of this is your choice, and you can pause or stop at any point.

When is surgery considered?

Surgery is not a treatment for family violence. It may occasionally be needed for a specific injury, such as a broken bone or a serious wound, and that would be arranged by the treating team in the usual way.

Living with this condition

Living with fear is exhausting, and everyday tasks can feel huge. Try to keep things simple: one small step at a time, one trusted person to check in with, and one support contact saved somewhere safe. Many people find it helps to have a plan for the times when risk feels highest — for example evenings, weekends, or when the other person has been drinking. You can plan without committing to leaving. Support workers will not push you faster than you want to go, and you can change your mind as often as you need.

Lifestyle tips

• Build or rebuild one connection outside the home — a friend, a family member, a faith group, a class, or a local service
• Keep a spare set of keys, some money, and essential medication somewhere you can reach easily
• Use safer technology: change passwords on a device the other person cannot access, review location sharing, and consider a pay-as-you-go phone
• Protect sleep and routine where you can — regular meals, daylight, and gentle movement help the body cope with stress
• Avoid relying on alcohol or drugs to manage fear, and ask for help if this is becoming a pattern
• If it is safe, keep up work, study, or volunteering — these can be a source of income, identity, and support

Diet and exercise

There is no special diet for this. Eating regularly, drinking enough water, and moving your body in any way you enjoy can steady your mood and help you sleep. Gentle activity such as walking, stretching, or housework counts. If you have injuries, ask a clinician what movement is safe. If money is tight, ask a support worker about local food and hardship help.

Mental health and emotional wellbeing

Fear and control take a real toll. Many people experience anxiety, panic, low mood, nightmares, trouble sleeping, shame, or feeling numb, and some develop post-traumatic stress. These are normal responses to abnormal stress, not weaknesses, and they can improve with the right support. It is common to feel love, anger, guilt, and hope all at once — that is not a sign you are doing anything wrong. If you ever feel you may harm yourself, please treat it as an emergency: call your local emergency number or a crisis line straight away, and tell someone nearby. You deserve support, and crisis help is there for exactly these moments.

Prevention

Family violence can be reduced. Prevention works at several levels: teaching children and young people about healthy relationships and consent; training healthcare staff to ask about safety at home; making sure support and housing are available when someone asks for help; and encouraging friends, neighbours, and colleagues to speak up when something seems wrong. If violence has already started, good support reduces the risk of it getting worse, and safety planning saves lives.

Screening programmes

Many health services now ask everyone a few routine questions about safety at home, for example during pregnancy care, mental health appointments, and emergency visits. This is called routine enquiry, and it helps people get support earlier. You can also start the conversation yourself at any appointment — you do not have to wait to be asked.

Complications

If left untreated

• Injuries that are not treated can get worse and lead to long-term pain or disability
• Strangulation can cause serious harm to the brain and breathing, sometimes days later, even if it seems mild at the time
• Abuse often becomes more frequent and more severe over time
• Anxiety, depression, post-traumatic stress, sleep problems, and in some people thoughts of suicide
• Harmful alcohol or drug use as a way of coping
• Unwanted pregnancy, sexually transmitted infections, and pregnancy complications
• Losing a job, a home, money, or contact with friends and family
• Children who witness or experience violence can have lasting effects on their behaviour, learning, and mental health
• Homelessness, and in the most serious cases, serious injury or death — which is why safety planning matters

Long-term outlook

Things can get better, and many people do get safe and rebuild their lives with the right support. Leaving is often a process rather than a single moment, and it is okay if it takes several tries. Services are there for every stage — talking, planning, leaving, recovering, and starting again. You are the expert on your own life, and good support should make you feel stronger, not managed. Reaching out once, even with a single question, is a real and brave first step.

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